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目的评价心理干预对伽玛刀治疗原发性三叉神经痛疗效的作用。方法2003年1月~2008年1月,48例经药物和其它保守治疗无效的原发性三叉神经痛患者接受伽玛刀治疗。其中男性22例,女性26例,年龄39~82岁,平均66岁。疼痛分布:第Ⅱ支8例,第Ⅲ支6例,第Ⅱ+Ⅲ19例,第Ⅰ+Ⅱ+Ⅲ支15例,选择照射部位为三叉神经根,使用4 mm准直器、双靶点治疗,靶点中心剂量75~85 Gy。在治疗前、中、后对患者进行心理干预,观察伽玛刀疗效。结果随访时间6~48个月,平均24个月,疼痛完全缓解34例(70%),疼痛缓解>50%仍需药物治疗者11例,疼痛缓解程度<50%或无效者3例,总有效率93%。结论伽玛刀治疗原发三叉神经痛安全有效,在治疗期间进行心理干预,可提高有效率,减少复发。
Objective To evaluate the effect of psychological intervention on gamma knife treatment of primary trigeminal neuralgia. Methods From January 2003 to January 2008, 48 patients with primary trigeminal neuralgia who were ineffective with drugs and other conservative treatments were treated with gamma knife. Of which 22 males and 26 females, aged 39 to 82 years, mean 66 years. Pain distribution: 8 cases of the second branch, 6 cases of the first branch, Ⅱ + Ⅲ 19 cases, Ⅰ + Ⅱ + Ⅲ branch in 15 cases, the irradiation site was selected trigeminal nerve root, the use of 4 mm collimator, dual target therapy , The target center dose 75 ~ 85 Gy. In the treatment before, during and after the psychological intervention for patients to observe the efficacy of gamma knife. Results The follow-up time ranged from 6 months to 48 months (mean 24 months). Pain relief was completely relieved in 34 cases (70%), pain relief was still more than 50%, medication was still required in 11 cases, pain relief was less than 50% or ineffective in 3 cases, Effective 93%. Conclusion Gamma knife treatment of primary trigeminal neuralgia safe and effective psychological intervention during treatment can improve the efficiency and reduce recurrence.